RESUMO
OBJECTIVE: To compare with pristine sites bone resorption and soft tissue adaptation at implants placed immediately into extraction sockets (IPIES) in conjunction with deproteinized bovine bone mineral (DBBM) particles and a collagen membrane. MATERIAL AND METHODS: The mesial root of the third premolar in the left side of the mandible was endodontically treated (Test). Flaps were elevated, the tooth hemi-sectioned, and the distal root removed to allow the immediate installation of an implant into the extraction socket in a lingual position. DBBM particles were placed into the defect and on the outer contour of the buccal bony ridge, concomitantly with the placement of a collagen membrane. A non-submerged healing was allowed. The premolar on the right side of the mandible was left in situ (control). Ground sections from the center of the implant as well as from the center of the distal root of the third premolar of the opposite side of the mandible were obtained. The histological image from the implant site was superimposed to that of the contralateral pristine distal alveolus, and dimensional variation evaluated for the hard tissue and the alveolar ridge. RESULTS: After 3 months of healing, both histological and photographic evaluation revealed a reduction of hard and soft tissue dimensions. CONCLUSION: The contour augmentation performed with DBBM particles and a collagen membrane at the buccal aspects of implants placed IPIES was not able to maintain the tissue volume.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Substitutos Ósseos/farmacologia , Colágeno/farmacologia , Carga Imediata em Implante Dentário/métodos , Doenças Mandibulares/prevenção & controle , Membranas Artificiais , Animais , Dente Pré-Molar , Cães , Fotografação , Extração Dentária , Alvéolo Dental/cirurgiaRESUMO
AIM: To evaluate the influence of deproteinized bovine bone mineral in conjunction with a collagen membrane, at implants installed into sockets in a lingual position immediately after tooth extraction, and presenting initial horizontal residual buccal defects <2 mm. MATERIAL AND METHODS: The pulp tissue of the mesial roots of (4)P(4) was removed in six Labrador dogs, and the root canals were filled with gutta-percha and cement. Flaps were elevated, and the buccal and lingual alveolar bony plates were exposed. The premolars were hemi-sectioned, and the distal roots were removed. Implants were installed in a lingual position and with the margin flush with the buccal bony crest. After installation, defects resulted at about 1.7 mm in width at the buccal aspects, both at the test and control sites. Only in the left site (test), deproteinized bovine bone mineral (DBBM) particles were placed into the defect concomitantly with the placement of a collagen membrane. A non-submerged healing was allowed. RESULTS: After 3 months of healing, one implant was found not integrated and was excluded from the analysis together with the contralateral control implant. All remaining implants were integrated into mature bone. The bony crest was located at the same level of the implant shoulder, both at the test and control sites. At the buccal aspect, the most coronal bone-to-implant contact was located at a similar distance from the implant margin at the test (1.7 ± 1.0 mm) and control (1.6 ± 0.8 mm) sites, respectively. Only small residual DBBM particles were found at the test sites. CONCLUSION: The placement of an implant in a lingual position into a socket immediately after tooth extraction may favor a low exposure of the buccal implant surface. The use of DBBM particles, concomitantly with a collagen membrane, did not additionally improve the outcome obtained at the control sites.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Carga Imediata em Implante Dentário , Extração Dentária , Animais , Regeneração Óssea , Bovinos , Colágeno/farmacologia , Cães , Membranas Artificiais , Minerais/farmacologia , Osseointegração , Retalhos Cirúrgicos , CicatrizaçãoRESUMO
AIM: To evaluate the influence of deproteinized bovine bone mineral (DBBM), in conjunction with a collagen membrane, on bone resorption at implants installed in a lingual position immediately into extraction sockets with horizontal residual buccal defects >2.0 mm. MATERIAL & METHODS: The pulp tissue of the mesial roots of (1) M(1) was removed in six Labrador dogs, and the root canals were filled with gutta-percha and cement. Flaps were elevated. The molars were hemi-sectioned and the distal roots removed. Implants were installed in a lingual position and with the shoulder flush with the buccal bony crest. After installation, defects of about 2.5 and 2.7 mm in width resulted at the buccal aspects of the test and control sites, respectively. Only in the left site (test), deproteinized bovine bone mineral (DBBM) particles were placed into the defect concomitantly with the placement of a collagen membrane. On the control sites, no biomaterials were applied. A non-submerged healing was allowed. RESULTS: After 3 months of healing, one control implant was not integrated and was excluded from the analysis, together with the contralateral test implant. All remaining implants were integrated into mature bone. The buccal alveolar bony crest was resorbed more at the test compared with the control sites, 2.2 ± 0.9 mm and 1.5 ± 1.3 mm, respectively. The vertical resorption of the lingual plate was 1.6 ± 1.5 mm and 1.5 ± 1.1 mm at the test and control sites, respectively. Only small residual DBBM particles were found at the test sites (1.4%). CONCLUSION: The use of DBBM particles to fill buccal defects of ≥2.5 mm at implants installed immediately into alveolar extraction sockets did not preserve the buccal bony wall.
Assuntos
Processo Alveolar/cirurgia , Substitutos Ósseos/farmacologia , Implantação Dentária Endóssea/métodos , Implantes Dentários , Osseointegração , Animais , Bovinos , Colágeno/farmacologia , Cães , Membranas Artificiais , Dente Molar , Retalhos Cirúrgicos , Extração Dentária , CicatrizaçãoRESUMO
AIM: To evaluate the influence of the presence of both adjacent teeth on the level of alveolar bony crest at sites where implants were installed into the socket immediately after tooth extraction. MATERIAL AND METHODS: Six Labrador dogs were used. Extractions of all teeth from the second premolar to the first molar were performed in the right side of the mandible, after full-thickness flap elevation. In the left side of the mandible, an endodontic treatment of the mesial root of the third and fourth premolars was performed. Full-thickness flaps were elevated, the teeth hemi-sected, and the distal roots removed. Immediately after, implants were bilaterally installed with the margin flush to the buccal bony crest. The implants were placed in the center of the alveolus at the third premolars and toward the lingual bony plate of the alveolus at the fourth premolars. After 3 months of healing, the animals were euthanized. RESULTS: All implants were integrated in mature bone. More bone resorption was observed at the test compared to the control sites. At the buccal aspect, a resorption of 2.8 ± 0.5 and 1.6 ± 0.4 mm at the third premolars and of 2.4 ± 0.6 and 0.8 ± 0.7 mm at the fourth premolars were found, at the test and control sites, respectively. At the lingual aspect, the bony crest was apically located in relation to the implant shoulder 1.5 ± 0.3 and 0.5 ± 0.5 mm at the third premolars and 1.6 ± 0.6 and 0.3 ± 1.1 mm at the fourth premolars, at the test and control sites, respectively. A lower buccal bone resorption was found at the control implants placed lingually. CONCLUSION: Multiple extractions of teeth adjacent to a socket into which implants were installed immediately after, tooth extraction induced more alveolar bone recession compared to sites where the adjacent teeth were preserved. Moreover, an implant placed more lingually yielded less recession of the buccal aspect of the implant.